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What Is The Cause And Treatment For Genital Dysaesthesia?

Posted on Fri, 7 Nov 2014

Question: The head of my penis is hypersensitive and is driving me crazy! I had a series of prostate massage treatments from my urologist but they didn't work. He does not know what to do with me. I've tried various numbing topical agents and using pressure with my fingers which gives me some temporary relief. Someone suggested botox injections at the head of the penis. What do you think is the problem and how can I get relief?

Answered by Dr. Rahul Tawde (1 hour later)

Brief Answer:
Evaluation and management of Genital Dysaesthesia

Detailed Answer:
Hi, thanks for posting the concern in the HCM.

The condition is known as genital dysaesthesia and your remark "driving me crazy" is the actual phrase that these patients say. Truly the problem is pretty embarrassing and also difficult to treat.
The condition is due to hyperactivity of the nerves supplying the penile tip or penis.
This may be idiopathic, or due to vascular problem, or hypersensitivity or pudendal nerve entrapment. The underlying cause must first be identified to succeed in treatment.

So, I would recommend you the following tests-
Complete blood count, CRP. Urea, Creatinine, electrolytes, fasting TSH, HbA1c, serum PSA
Urine for Routine analysis and culture sensitivity
USG whole abdomen
MRI Lumbosacral spine

For the time being I would advice you some medication and precautions. These are-
1. Stop using any cosmetic product, soap, solution or cream.
2. Use Boxer shorts
3. 1% Menthol in aqueous cream applied 3 to 4 times daily locally.
4. Tab Amitriptyline 25 mg one tab at bedtime. This is a prescription medicine.
Please consult a local neurologist for further evaluation.

If you find this answer helpful, please close the thread and rate my answer.
Regard.
Dr. Kaushik Sarkar

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Rahul Tawde (1 hour later)

So you wouldn't recommend Botox injection into the head of the penis? Could I use neurogel instead of the menthol - it is a compounded cream with amitrypti- lene in it. I use it for neuropathic pain in my gum tissues - it is very numbing.

Answered by Dr. Rahul Tawde (17 hours later)

Brief Answer:
neurogel can be used

Detailed Answer:
Thanks for your reply and sorry for being so late.
I am really flattered to find your appreciation and believe me, these are the inspiration for our work.
Now, regarding the question, I would say botulinum toxin injection is not the choice now. It would be the last resort for absolutely refractory condition. But, neurogel can be used now.
But, you should also consult a local neurologist as I have said previously.
If you have any other questions, please write back to me directly.
To rate my answer, you can close the thread and rate it with number of stars you want to give out of five. I again thank you sincerely for your remarks.
Regards,
Dr Kaushik Sarkar

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Above answer was peer-reviewed by : Dr. Shanthi.E